Tuesday, July 3, 2007

Over the weekend, I took the opportunity to see Michael Moore's new film, Sicko. Unless you've been living in a cave you will know by now that Sicko represents Moore's take on the American health care system. It is an indictment of "for-profit" healthcare and the many Americans it leaves without adequate coverage.

I've said it here before: I like Michael Moore. He is a gifted filmmaker and above all else, he knows how to make a compelling argument. On this front, Sicko does not disappoint. Moore himself is less visible in this film than he has been in some of his previous efforts. For the most part, he lets his featured subjects do the talking. And their stories are truly horrific. A man without health insurance is forced to choose which of two fingers to re-attach after an acccident with a saw. A couple is forced to sell their home to pay for medical expenses. A young mother watches her child die after an ambulance takes them to a hospital that is not approved by their insurance company. Insurance industry insiders reveal tactics used to deny claims. And the list goes on. These tales are heart-wrenching, and illustrate the significant fractures in the American healthcare system.

Moore goes farther, visiting hospitals in Canada, England and France and speaking with citizens of all three countries about the advantages of public healthcare. And in a final flourish of sensationalism, he takes a group of 9/11 volunteers with chronic illness to Cuba. The group are hospitalized, investigated and treated - gratis of course. Moore's detractors often point to such stunts as distortions of the truth. And they are likely correct. No hospital (in Cuba or anywhere else) would hospitalize foreign nationals for inpatient investigation of chronic illness, free of charge. And Moore's characterizations of healthcare systems in Canada, Britain and France are hardly comprehensive and clearly designed to illustrate their benefits rather than their flaws.

Moore makes no apologies for this (nor should he). As he rightly points out, the film is aimed at Americans who have been told for years the lie that public healthcare is without merit and akin to communism. And despite the liberties taken in the storytelling, the story itself is important. Sicko implores us to consider the reasons why the wealthiest country in the world seems so unwilling to provide comprehensive affordable health coverage for each of its citizens. We are confronted with the stark reality that when profit and healthcare collide, profit usually triumphs. In one of the most revealing but underdeveloped storylines, Moore plays White House tapes of a conversation between Richard Nixon and John Ehrlichman in 1971 that led to the HMO act of 1973.

President Nixon: “Say that I … I … I’d tell him I have doubts about it, but I think that it’s, uh, now let me ask you, now you give me your judgment. You know I’m not to keen on any of these damn medical programs.”

Ehrlichman: “This, uh, let me, let me tell you how I am …”

President Nixon: [Unclear.]

Ehrlichman: “This … this is a …”

President Nixon: “I don’t [unclear] …”

Ehrlichman: “… private enterprise one.”

President Nixon: “Well, that appeals to me.”

Ehrlichman: “Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because …”

President Nixon: [Unclear.]

Ehrlichman: “… the less care they give them, the more money they make.”

President Nixon: “Fine.” [Unclear.]

Ehrlichman: [Unclear] “… and the incentives run the right way.”

President Nixon: “Not bad.”

It's hard not to be moved by Sicko. At times it's flamboyant and sensational. But its best moments are the quiet ones, the ones filled with the sad stories of people on the wrong end of America's capitalist dream.